HomeMy WebLinkAboutMortgage_Heltsley°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
_ FOR DEDUCTION FROM ASSESSED VALUATION
SUIe Fortn 43709 (RB / 2-07)
�' :w � Resabed by DeVartmmt of Local GooemmeM Fi,wwxe
INSTRUCTIONS:
To be filed in person or by mad with Me Cou/rtyAuditor of the county whera Ure property is �
Fding Dates: 7) Real Pr�perty: During the 12 monMs belare June 11 07 fhe year the deduction At to be elfective.
2J Mobile Hames assessed'mdei IC 61. 7-7: Behveen January 15 and March 2 of the y� the deducp� to be eHective.
See reverse side /a addtional insWctions ard qualifications. � � 1
Aodicant (owneror by'er-see rcsbici'ws m MNS6 �a) `�'ll _._ ,Q
7" Di ' (/ Key n"ibu I Iegal des tion
� '
A4�ed vdlue of 2al popety as af March . arrent y�r Mortgage I Contr
wnent year /
i
�wnz� �s n�s i ne� e,�aa s��e a �me�esi?
/
If rqme m recortl is d'Afeiart than Ihal oF applican4 indiot� /
Name ot mongagee or canf`aa seller
Address of moAgagee u mn
Name of assqnee or
IicaN wT p/Op2rty �n arry
Indana?
❑ Yes
��—U�
unpaid as of March 1,
C�
�` , �/
� �/' 1 � J
❑ No r � �� Q
`� —�� ✓
� �
Is Ue appGmnt lhe sole
❑Yes ❑No
spouse.
he property in questim:
Real Property ❑ Mobile Hrnrne QC 61.
Has Uds deduclian been requrstetl on ryoperry
fa artent yea/7
❑Yes ❑No
Deductbn aPV�'� in Uie amwnt of: � ( �S /
\�
Zp pp ��!%� � 20 _ 20 20
sigrawre ot Counry Audnor ��ry D� (��. �Y Y��
I/ We certify under ihe penalry of perjury that e above and fwcgoing infortnaCOn is hve and correct and that the appGcanLS was / were a resident of
Indiana and owner of the aforert�entirn�lp operty on March 7, 20
c�,���.oi�W.a,d(eain,,m..1� Daie(monfh.daY•Y�� .
N� V t ac t+a K
duty ezewted Power of Nbmey or by I
AdCress of aulhorized peism (number arM street aty, state. aM LP oode)
�/ y�c39
Dale